电视胸腔镜手术在老年患者中的应用  

The Application of VATS in the Elderly

作　　者：姜杰[1] 黄孕西[1] 许胜水[1] 颜松龄[1] 兰俊斌[1] 

机构地区：[1]厦门市第二医院胸外科,361002

出　　处：《福建医药杂志》2001年第4期5-7,共3页Fujian Medical Journal

摘　　要：目的　探讨电视胸腔镜手术 (VATS)在老年胸部疾病诊治中的应用价值。方法　老年 VATS 42例 ,占同期 VATS的 31.8% ,年龄 6 0～ 82岁 ,病种主要有自发性气胸、肺癌、脓胸、胸膜间皮瘤等。共行肺大泡治疗 16例 ,胸液清除及胸膜活检 11例 ,肺叶切除 4例 ,肺楔形切除 3例 ,间皮瘤切除 2例 ,心包开窗术 2例 ,纵隔肿瘤切除 1例 ,血胸清除、肺修补术 1例 ,另 2例中转开胸。结果　电视胸腔镜手术时间 30～ 2 40分钟 ,平均 70分钟。术后平均住院时间 10 .6天 ,无手术死亡。术后发生并发症 9例 (2 1.4% ) ,包括心律失常、肺漏气大于 7天、肺部感染等 ,经处理后均治愈。结论　VATS对老年患者较传统开胸手术创伤小、并发症少、恢复快 。Objective\ To assess the diagnostic and treatment value of video assisted thoracic surgery(VATS)in the elderly Methods The outcome of VATS in 42 cases of elderly patients was analyzed retrospectively.The patients ranged in age from 60 to 82 years,and were mainly ill with spontaneous pneumothorax,lung cancer,purulent pleurisy,pleural mesothelioma.The procedures included bullae treatment in 16 cases,pleural biopsy and debridement in 11,lobectomy in 4,wedge resection in 3,resection of mesothelioma in 2,pericardial window in 2,resection of mediastinal tumor in 1,hemothorax cleaning and pneumonorrhaphy in 1.Results\ The mean operating time was 70 minutes,and the mean postoperative hospital stay 10 6 days.There were no operative death and 2 conversions to open thoracotomy.9 cases were associated with a postoperative complication for an overall morbidity rate of 21 4% Arrhythmia,prolonged air leak were the main complications.Conclusions\ VATS is feasible in the elderly and safe even in elderly patients with chronic heart or lung diseases.

关 键 词：老年人 电视胸腔镜手术 VATS 

分 类 号：R655.3[医药卫生—外科学]